Urogynecology

Dr. Jeffrey Hantes has always taken an interest in urinary bladder dysfunction and pelvic organ prolapse. His continued research of the disorders and developments in treatment make him an expert in the field. After years of extensive training, he is
considered an authority on the disorders and can perform both classic and cutting-edge treatment procedures.

Choosing an experienced, compassionate physician for the treatment of bladder dysfunction or pelvic organ prolapse is
imperative. The field is highly specialized, and doctors must undergo extensive training before treating patients for these
disorders.
Dr. Hantes’ office is uniquely situated to deliver complete care for women presenting with Pelvic Organ Prolapse and Urinary
Bladder Dysfunction. His scope of practice includes the treatment of Uterine Prolapse, Vaginal Wall Prolapse (cystocele,
rectocele, enterocele), Urinary Incontinence (stress, urge, mixed), Fecal Incontinence, and Interstitial Cystitis (painful bladder
syndromes). In addition, Dr. Hantes provides advanced laparoscopic and vaginal techniques offering patients less invasive
surgical approaches.
In-office Sonography, multi-channel cystometrics/urodynamics, cystoscopy, and biofeedback are available to provide a complete
evaluation without the need for additional referrals. Extensive patient education is provided in a comfortable environment
dedicated to health care for women.
Having the ability to treat both gynecological and urological problems without the need for additional referrals provides
convenience for you and your family.

A sample of procedures performed by Dr. Hantes:

• Treatment of Urinary Incontinence (leaking with coughing, laughing, or exercise) using the Trans obturator Mid-Urethral
  Sling procedure. This procedure does not require hospitalization and the patient may return to work in 3 days. Using the
  Trans obturator approach results in less pain when compared to the older Transvaginal approach.
• Treatment of Uterine Bleeding using in office ablation. Uterine ablations can be done in the office or outpatient facility
  under light sedation. The procedure takes less than 10 minutes to perform, and no incisions are required. Patient must
  not desire future fertility.
• Treatment of Uterine / Vaginal Prolapse using advanced vaginal mesh techniques to achieve superior results as compared
  to older surgical techniques. These procedures are highly evolved representing the latest techniques available.
• Laparoscopic Hysterectomy to remove the uterus on an outpatient basis.
• Advanced Vaginal Hysterectomy. Removing the uterus vaginally in patients with fibroids, or prior cesarean section.

In addition to the above procedures, the following conditions and treatments are offered:

• Treatment of Urinary Bladder Dysfunction including urgency incontinence and Interstitial Cystitis
• Urinary Bladder evaluation using multichannel Cyst metrics
• Advanced Uroflow Diagnostics & Pelvic Rehabilitation
• Urinary Bladder Biofeedback training

 
Please refer to below for a more complete list of procedures and treatments of pelvic organ prolapse:

• Anterior Repair or Anterior colporrhaphy 
  A vaginal procedure to reestablish the supports between the bladder and vagina to fix a cystocele (bulging of the urinary
  bladder into the vagina) . The old procedure used suture to pull the tissue together to repair the hernia. Today a synthetic
  mesh or organic graft material is placed to reinforce this repair
• Paravaginal repair (vaginal or abdominal approach) 
  Similar to the Anterior Repair but the support of the vaginal wall is achieved by attaching it to the pelvic sidewall. A
  synthetic mesh or organic graft material is placed to reinforce this repair
• Posterior Repair or Posterior colporrhaphy 
  A vaginal procedure to reestablish the supports between the vagina and rectum to fix a rectocele (bulging of the rectum
  into the vagina). The old procedure used suture to pull the tissue and muscles together resulting in an anatomically
  incorrect repair that can cause pain during intercourse. Today a synthetic mesh or organic graft material is placed to
  reinforce this repair
• Supracervical Laparoscopic hysterectomy (with or without removal of Fallopian Tubes and Ovaries) or LASH Procedure
  Remove the uterus, leaving the cervix by laparoscopic technique.
• Total Laparoscopic Hysterectomy 
  removal of the uterus (including the cervix) and possibly the tubes and ovaries through a laparoscopic approach
• Total vaginal hysterectomy (with or without removal of Fallopian Tubes and Ovaries) Remove the uterus (including the
  cervix), tubes and ovaries through a vaginal incision.
• Bilateral salpingo/oophorectomy or BSO
  Removal of tubes and ovaries
• Uterosacral ligament suspension 
  Suspend the top of the vagina to the uterosacral ligaments, one of the original supports of the uterus and vagina.
• Sacrospinous vaginal vault suspension 
  A vaginal procedure that attaches the top of the prolapsed vagina to a ligament in the pelvis. An anatomically incorrect
  repair resulting in the vagina being pulled to one side of the pelvis.
• Sacral colpopexy 
  A procedure (performed abdominally or laparoscopically) that attaches the top of the prolapsed vagina to the sacrum
  using either synthetic mesh or cadaveric material.

Please refer to below for a more complete list of procedures and treatments of Stress Urinary Incontinence:

• Sub urethral sling 
  Placing a “strap” of material under the urethra to support it and prevent stress incontinence. The sling material can be
  synthetic or natural. The natural material can be taken from your own body or from cadavers.
• Periurethral injections
  Injection of material next to the opening of the bladder in an effort to prevent stress incontinence. This procedure is
  performed in the office.
• Tension-free vaginal tape sling TVT 
  A special type of sub urethral sling that requires a less invasive procedure, which allows it to be performed under light
  sedation on an outpatient basis. This procedure brings the sling material through the vagina and exiting the abdominal
  wall. It results in more patient discomfort in my opinion than the Trans obturator Mid-Urethral Sling procedure
• Trans obturator Mid-Urethral Sling procedure TOT 
  A special type of sub urethral sling that requires a less invasive procedure, which allows it to be performed under light
  sedation on an outpatient basis. This procedure requires 3 small incisions and has been tolerated by patients very well.
• Neuromodulation/Interstim
  This is a new approach in the treatment of the overactive bladder, urinary retention, and urinary frequency. Electrodes are
  surgically inserted into the nerves that control the bladder.